Medial Patellofemoral Ligament (MPFL) Reconstruction in Combination with a Modified Grammont Technique Leads to Favorable Mid-term Results in Adolescents with Recurrent Patellofemoral Dislocations

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2017 Feb 18

PMID 28210789

Citations 3

Authors

Helmut Wegmann

Christoph Wurnschimmel

Tanja Kraus

Georg Singer

Robert Eberl

Holger Till

Matthias Sperl

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure.

Methods: MRI examinations were obtained pre- and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI. The Tegner Activity Scale and the Kujala Knee Score were assessed preoperatively and at follow-up. The Kujala Knee score and the IKDC 2000 knee score were documented at follow-up (median 50, range 20-61 months; SD 16.6).

Results: Seven knees of six patients (median age 16.5 years, range 14-17 years) with trochlear dysplasia and elevated TTTG distance (median 17 mm, range 16.1-21.9 mm; SD 2.8) were treated. Trochlear dysplasia was classified as Déjour type A in 1, type B in 5, and type C in 1 knee. The Kujala Knee Score significantly increased from values of 55 (range 17-88; SD 25.9) to 94 (range 73-100; SD 9.1) at follow-up (p = 0.028). TAS improved from preoperative 2 (range 0-7; SD 2.5) to 5 (range 4-9; SD 1.8) at follow-up (p = 0.034). Median IKDC 2000 Knee Score at follow-up was 89 (range 61-100, SD 13.4). No re-dislocations were encountered.

Conclusion: In selected adolescents with recurrent patellofemoral instability, MPFL reconstruction in combination with a modified Grammont technique yields excellent functional outcome and could, therefore, help to avoid major procedures, such as osteotomies.

Level Of Evidence: Therapeutic, Level IV.

Citing Articles

Effects of Lateral Patellar Retinaculum Release for Recurrent Patella Dislocation: A Prospective Study.

Wang X, Peng C, Tu Y, Liu Y, Zhang W, Zhang Y Int J Gen Med. 2021; 14:5527-5535.

PMID: 34531678 PMC: 8439663. DOI: 10.2147/IJGM.S329026.

Good outcomes of modified Grammont and Langenskiöld technique in children with habitual patellar dislocation.

Musielak B, Premakumaran P, Janusz P, Dziurda M, Koch A, Walczak M Knee Surg Sports Traumatol Arthrosc. 2020; 29(6):1983-1989.

PMID: 32980886 PMC: 8126540. DOI: 10.1007/s00167-020-06284-y.

Recent developments in evaluation and treatment of lateral patellar instability.

Zimmerer A, Sobau C, Balcarek P J Exp Orthop. 2018; 5(1):3.

PMID: 29322270 PMC: 5762615. DOI: 10.1186/s40634-017-0119-z.

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